Coordinated Response

1013Flight-for-life

New North region health care professionals come together for FEMA disaster preparedness training

Story by Robin Driessen Bruecker

With the many news reports on how the federal government spends our taxpayer dollars, it’s always good to hear when that money is applied to deserving programs.

Which programs are designated as deserving may vary from one political viewpoint to the next, but perhaps everyone can agree that emergency preparedness for multiple-vehicle or train accidents, epidemics, natural disasters, terrorist attacks, etc. in one’s own region is a worthwhile expenditure.

The Federal Emergency Management Agency provides this training to hospitals and emergency responders in every state. This past June, Wisconsin delegates from 43 health care systems and hospitals spent a week at FEMA’s Center for Domestic Preparedness in Alabama. Among them was a group of New North health care professionals from Affinity Health System, ThedaCare and Aurora Medical Center in Oshkosh.

Tracey Froiland is not only the emergency management coordinator for Appleton-based ThedaCare, but the registered nurse is also manager for Region 6 of the Wisconsin Hospital Emergency Preparedness Program, which was involved in organizing the Alabama “Wisconsin Week” trip.

“Several people from around the state have attended this training before individually,” Froiland noted. “We just broke tradition and took a large group.”

Training regimen

The group left Wisconsin June 9 and began five days of training the next day. Three courses were offered: emergency medical operations, which covered incidents involving chemical, biological, radiological and nuclear weapons plus explosives; and health care leadership and hospital emergency response training, both for mass-casualty incidents. The cost of taking the courses was covered by FEMA, which also paid for the participants’ travel expenses, lodging and meals.

“For the week, we were broken out into three different groups,” said Tracy Warren, emergency room registered nurse at Aurora Medical Center in Oshkosh. Besides Warren, Aurora sent eight staff to Alabama, including ER nurses, house supervisors, a facilities administrative assistant and manager, and an infection prevention specialist.

The pre-hospital emergency medical operations group, Warren continued, consisted of paramedics in addition to emergency medical service and air medical personnel, who rescue victims and do brief decontamination at the scene. The health care leadership group was involved in hospital operations, while the hospital emergency response training group handled rapid triage, decontamination of ambulatory and non-ambulatory patients, and post-decontamination, she explained.

“The (hospital emergency response training) team consisted of not only nurses, but ancillary staff as well. The reason for this is in the event of a disaster, nursing personnel will be needed to perform life-saving care. The (hospital emergency response training) team is in place to protect the ‘house.’ The hospital is the house. If they fail, the house, staff and existing patients are contaminated.”

Real simulation

The courses weren’t just classroom learning – scenarios of real-life incidents were staged to provide hands-on training and get a feel for the issues, emotions, stress and other challenges that can arise from an emergency.

“We had classroom-style learning sessions, tabletop exercises and then functional exercises,” explained Deb Cross, a registered nurse who is director of emergency management for Affinity NurseDirect, LifeSpan and LifeDirect – all services of Menasha-based Affinity Health System. Cross also serves as a representative at WHEPP meetings.

Cross attended the FEMA training with 17 other members of Affinity and 13 from Ministry Health Care – the parent organization for Affinity. Among them, their diverse roles included senior administrative assistant, paramedic, coordinator for security, manager of patient care, the team leaders for hospital services and supervisor of environmental services.

“We had representation in all three courses from our system. I was in the health care leadership,” Cross said.

Members of the health care leadership group played various roles, such as patient intake and bed placement, security and public information.

“We spent a lot of time in hazmat training, including triage, initial medical response and rescue,” noted Froiland. “The (health care leadership) was a lot of hands-on incident command training. I think that the hazmat training was so comprehensive and that is something we may need at any day and time. But the best part of the training was the ‘real’ settings that we trained in. There were days that we put over 100 real/acting patients through the hospital. They were yelling at us, acting out and it was emotionally draining, just like a real incident would be.

“Hospitals train for many possibilities. The most likely disasters are weather-related incidents, large-scale crashes, active-shooter incidents and infectious disease outbreaks.”

Warren explained that the classroom and field training for each area culminated on the last day with a “full-scale, four-hour, real-time event” that united the three groups and used a full-scale subway and a hospital.

“We were treating not only state-of-the-art mannequins, but real-life actors who were not only victims from the disaster but also played the role of other patients who would come to the hospital at any given time,” Warren said. “About 160 patients were decontaminated and brought into the 16-bed ER” at the Noble Training Facility, a former Army hospital.

“There was no diversion – we had to treat these patients in real time, develop alternate care sites within the hospital for our walking wounded, and truly test our surge plan. The mannequins were able to talk and interact with the staff and we were able to treat them just like a real patient – intubate, needle decompress, IV, etc., and visually see the effects of our interventions.”

Practical applications

Cross noted several types of emergencies can involve New North health care facilities and professionals, such as chemical spills, bus or multiple-car accidents, plane crashes, tornadoes and other bad weather, as well as power outages. Since the FEMA training, she has shared what she learned with other colleagues who didn’t attend.

“The experience of attending the training was priceless,” said Cross. “To have so many players gathered together from one area, each working through how to handle every situation we were faced with, was a rare occurrence. In the past, areas worked more in their own silos, doing what they do best, but others not knowing what they were doing. This really helped reinforce the advantages of all working together and knowing what each other does so that we can be more effective and efficient.”

Warren named a few local summer entertainment events in which the new knowledge and training was applied. One is the Tough Mudder race held last month in Oshkosh, which she said has been known to have injuries. Then there’s the EAA AirVenture, which was estimated to have had more than 500,000 people in attendance this past summer, and Country USA, which saw about 167,000 visitors this year.

“We prepare for these events by increasing our staffing, having extra supplies, an extra surgery call team available, and everyone is placed on alert,” said Warren. “This training has really broadened our knowledge of how to prepare for these events and potential emergencies in our communities.”

That knowledge is being passed on to other staff who weren’t part of the FEMA trip.

“This is a working project as we speak,” explained Warren. “We began with a presentation to hospital leadership about the week and what we learned and what our opportunities were for improvement. We are in the process now of planning training for the hospital and clinic. This will also eventually include training with the Oshkosh Fire Department and eventually Mercy Medical Center (in Oshkosh) for a combined city-wide drill. Our community will benefit from the training we received.”

“An amazing opportunity”

It’s difficult to find the words to describe what was learned from the FEMA training, Warren said.

“It was an amazing opportunity to train as a state, and work together to accomplish the same goal. We all brought something different to the table and we were able to share ideas and learn from each other. There is no other training available like this in the U.S. We had a full-scale working hospital to staff, full-scale subway system, live actors as well as million-dollar mannequins as victims.”

“We learned that training together is key! And that practice really makes you better,” ThedaCare’s Froiland said of the group’s experience at the Center for Domestic Preparedness. “It was a great experience I wish all emergency responders could attend. The entire experience was first-class. Being able to bring over 135 people from around the state to train in a real, live setting together was something we could never do without this opportunity. We all met new partners in our courses that may come in handy someday in a real event.”

Maintaining patient safety and preparing for potential disasters of various types are something hospitals have always done, Cross noted.

“The difference with the FEMA training was that we practiced with our partners, other health care facilities, county EMS, paramedics and others. This creates a community response to a disaster that is good for everyone.

“The community will benefit from the training by having a more collaborative approach to any disaster response,” said Cross. “When all partners have had the opportunity to work more closely together and practice together, it results in a more rapid and comprehensive response to any situation.”

Robin Bruecker has 17 years experience in magazine and marcom writing. Contact her at robinbrueck@yahoo.com.